De Quervain’s Disease is a cumulative trauma disorder or musculoskeletal injury that can cause thumb pain. A splint may be required 24 hours a day for 4 to 6 weeks.
What is a CTD?
A Cumulative Trauma Disorder (CTD) is an injury to the musculoskeletal system.
“During working years (ages 18 to 64) more people are disabled from musculoskeletal problems than from any other category of disorder.” (1)
Most musculoskeletal injuries develop gradually as a result of repeated micro-traumas.
De Quervain’s Disease:
De Quervain’s Disease is an inflammation of the tendon sheath of the thumb; it affects the tendons on the side of the wrist and at the base of the thumb. This condition may cause pain at the base of the thumb.
Tendons are rope-like structures that connect muscles to bones and transfer motion from the muscle to the bone. Tendons can be torn like frayed rope or can be inflamed because of overuse causing pain.
“De Quervain’s Disease is named after the French physician who first described it.” (1)
The condition can occur gradually or suddenly; and the pain may travel into the thumb or up the forearm.
De Quervain’s Disease can be caused by:
a direct blow to the thumb,
repetitive grasping; and
certain inflammatory conditions.
“Combinations of hand twisting and forceful gripping, similar to a clothes-wringing movement, will place sufficient stress on the tendons to cause De Quervain’s disorders.” (2)
Women Affected More Than Men
This condition affects women eight to ten times more than men.
What to do
Medical evaluation is encouraged.
Splint for Six Weeks
Treatment usually involves wearing a splint 24 hours a day for four to six weeks to immobilize the affected area and avoid movements that aggravate the symptoms.
Analyze Job Requirements
Job requirements should be analyzed and recommendations provided.
Dictation Software May be Helpful
If you spend a lot of time using your thumbs while texting on Social Media, you may want to consider using the voice activation software on your phone.
Cumulative trauma disorders, “A manual for musculoskeletal diseases of the upper limbs,” Edited by Vern Putz-Anderson;
Lamphier, T.A., Crooker, C. and Crooker, J.L., 1965, De Quervain’s Disease. Ind. Med. and Surg., 34 847-856
“A History of Seating in the Western World” discusses ergonomics beginning with ancient Egypt through the modern ergonomics professional.
It is a research paper based on the Postgraduate Diploma in Ergonomics Research project performed by Kim Gurr under the supervision of Leon Straker, Physiotherapy, and Phillip Moore, Social Sciences, at the Curtin University of Technology in Perth, Western Australia.
Unfortunately, Ms. Gurr died before finalizing her research. Following are quotes from the above-mentioned research paper:
Seating is Important for Ergonomics
“Seating is an important issue for contemporary ergonomics. Its frequent use by humans and its association with musculoskeletal disorders are just some of the reasons for its importance.”
Ancient History of Seating
“To understand the place of seating in modern Western societies, it is useful to understand its history.”
Modern History of Western Seating
“This paper presents an overview of the ancient history of seating and the modern history of Western seating with particular emphasis on the design influences over the past 5,000 year period.”
History of Seating Beginning with Egyptians
“The history of supporting sitting or seating has a long and colorful history beginning, at least, with the Egyptians some 3,000 B.C.”
History Summarized from Variety of Texts
“The historical knowledge summarized here (in Kim’s research paper) is distilled from a great variety of texts, for it seems our fascination with the chair is as alive today as it was in ancient times.”
Only Three Types of Seats Developed
“It should be noted that despite the huge amount of information documented on seat types, only three types of distinctly different seats developed. These were:
“the stool (both fixed and folding);
“the bench and its antecedent, the chest;
“and the chair.”
Carpenters to Ergonomics Professionals
“Basically, the initial chair or seat-makers were the carpenters and then the joiners, who were followed by the cabinet makers and craftsmen.”
“They were followed by the decorator; then the upholsterer, until the beginning of the Twentieth Century. ”
“At that time, the inventor emerged to be closely followed by the architect, and then by the professional designer.”
“Most recently, seating has become part of the domain of the ergonomics profession.”
Ergonomics Professionals’ Seating Model
“Ruptures” in Progression of Seating / Ergonomics
“The study of history can sometimes fool us into the belief that societies progressively improve on what has come before, as our body of knowledge increases.”
“This notion is dubious, and the reader will note the ‘ruptures’ in the historical progression of seating within Western culture.”
“The ancient history of furniture comes to us principally from the art records left to us by earlier societies.”
“Occasionally, such as in the case of Tutankhamen’s Tomb, real pieces can be examined and described firsthand.
History of Ergonomics Based on Pictorial Records
“Given that this history is based principally upon pictorial records, some generalizations are often made by writers in the field to create a cohesive picture for their readers. This paper should be read with this caveat.”
The Egyptian Era (3,100 – 475 B.C.)
“The Egyptian Era (3,100 – 475 B.C.) – The stoolappears to be the most common and perhaps, earliest pieces of furniture developed by early Egyptian culture, as seen in the early sculptures. It was used throughout society for a variety of functions.”
Stool to Chair with Backrest / Cushion
“By the time of The Second Dynasty, the stool appears to have differentiated into a new form reserved for royalty and high-ranking members of society.”
“It became more substantial in its construction, sometimes having a low backrest and was often higher than the stool.”
“Sometimes a cushion was added, or so it would appear from historical records.”
“The addition of a low backrest to the chair is an interesting development that is not seen again in the history of the chair.
“From the historical record, it would seem the low backrest is supporting the pelvis and sacrum in a fixed orientation, allowing the lumbar spine to move fore or aft to a point of balance.”
Chair Unchanged for Twelve Dynasties
“By the Fourth Dynasty, the chair reached a high point in its refinement and elegance.
“After that time-period, the seat in its two forms:
“the chair used by nobility and royalty, and
“the stool used throughout the rest of the society
“remained virtually unchanged for twelve dynasties (to around 1,320 B.C.).”
“It is also interesting to note:
“the footstool with some of the taller chairs.”
Twelve Dynasties – No Mention of a Standard Size
“The sitting postures shown with the legs hanging down resemble very closely that shown in anthropometric tables used by today’s furniture designers, with the thighs being parallel to the floor.”
Office Ergonomics – Correct Sitting Posture
“No mention was made in the literature reviewed as to whether the furniture was custom-made for individuals or whether a standard size had developed.”
The Ancient Mesopotamian Era
“The Ancient Mesopotamian Era – The Mesopotamian empire developed concurrently with the Egyptian culture; and it is clear that there was some interaction between the two, as seen in the similarity of some of their furniture.”
“It is known that stools and some chairs were in use around 3,100 – 2,370 B.C., as evidenced in the remains of pottery and seals recently excavated; however, beyond this, there is little record of this period.”
The Akkadian Period – End of The Kassite Period
“The Akkadian Period – From the Akkadian Period to the end of The Kassite Period (2,370 – 1,500 B.C.), evidence of cross-legged stools and a box-shaped stool with lattice side panels are found.”Middle Babylonia / Kassite Period (ca. 1595-1155 B.C.) in Mesopotamia
“Modern chronology uses the sack of Babylon by a Hittite army in 1595 B.C. as the dividing line between the Old Babylonian (1894 – 1595 B.C. and Middle Babylonian 1595-1155 B.C.) periods in Southern Mesopotamia.”
Who Were the Kassites?
According to Wikipedia – “The Kassites were people of the ancient Near East, who controlled Babylonia after the fall of the Old Babylonian Empire c. 1531 B.C. and until c. 1155 B.C.”
Woven Rush – A Craft Known From Prehistoric Times
“The seats with the grid pattern in their sides have special interest not only because of the frequency with which they appear in the seals of the period, but also because of the resemblance to a construction popular in Iraq today (1980’s).”
“Crates to hold vegetables and fruit are made in the same manner; and it seems likely that we have here an example of a craft that has continued with little change for more than 4,000 years.”
“The seats of the chairs are made of woven rush, a craft known from prehistoric times, (Baker, 1966).”
The Assyrian & Neo-Babylonian Periods (1,350 – 539 B.C.)
“The Assyrian and Neo-Babylonian Periods in Mesopotamia (1,350 – 539 B.C.) – The chair and table are seen being used together in artifacts depicting eating scenes. The chair is of a high-backed variety, similar to that developed in Egyptian culture . . . From the records remaining from this period, it seems the high-backed chair, often used with a footstool remained furniture of royalty and a privileged class.”
The Aegean Era – (3,000 – 2,000 B.C.)
“The Aegean Era (3,000 – 2,000 B.C.) – The Aegean region was to become a cultural center for the development and refinement of supported sitting, and most particularly with regard to the chair. However, few records remain of this period to indicate the types of furniture used.”
The Minoan Era – (2,000 – 1,000 B.C)
“The Minoan Era (2,000 – 1,000 B.C.) – The Minoans’ furniture history comes to us from the excavated ruins of the ‘Palace of Minos’ at Knossos. . .Unfortunately, Knossos was destroying most of the relics from their (own) civilization. The throne of Knossos, constructed of stone, is one of the few remaining examples. . .”
NOTE: The Throne Room was a chamber built for ceremonial purposes during the 15th century B.C. inside the palatial complex of Knossos, Crete, in Greece.
The Mycenaean Era – (1,600 – 1,200 B.C.)
“The Mycenaean Era (1,600 – 1,200 B.C.) – This era remains of great intrigue to historians as few records remain. It is the time of Homer and the Odyssey. Our knowledge of this time is constructed from the tales passed down through the generations; and, most recently, from the deciphering of some stone tablets in which chairs, tables, and footstools are mentioned.”
“‘The descriptions give but few clues to the actual appearance of this furniture,’ (Baker, 1966).
It is known they (during the Mycenaean Era) used:
“high seats requiring the use of a footstool, and
“chairs with backrests that could be moved with some ease.”
Mycenaean Civilization – All Records Lost
“The Mycenaean civilization ended abruptly around 1,200 B.C. with the palaces burned and all records lost.”
“The next five hundred years remain a blank as far as the archaeological record of furniture is concerned; and this period is sometimes referred to as the ‘dark ages’ of Greek history.”
The Early Greek Era
“The Early Greek Era – This is a period of sophistication in design represented in the paintings and sculpture of the time.”
Greeks Accustomed to Eating in a Reclining Pose
“Banquet couches for sleeping or dining are common. The Greeks had become accustomed to eating in a reclining pose . . .The designers and craftsmen of this period produced a well-finished and what is often referred to as ‘classic’ Greek design in the chair.”
“‘Sometime in the early part of the Fifth Century B.C., the chair acquires a broad horizontal back slat at the top that encircled the shoulders of the seated person, and a fixed for of the classic chair is established. The backs of some chairs sweep back in an exaggerated curve, while others are straighter,’ (Baker, 1966).”
The Classical Greek Era (475 – 370 B.C.)
“The Classical Greek Era (475 – 370 B.C.) – The furniture of this period remained virtually unchanged from the ‘Early Greek Era.’
“‘The Classical Era,’ as it pertains to furniture and architecture, continued without break in Greece and the Roman World until the time of Constantine; and although interrupted for long intervals, its influence has continued until today,’ (Baker, 1966).”
“The chairs, stools, couches, and tables of this time have remained an inspiration to furniture designers, determining form and functional use patterns by Western cultures.”
“The stool developed in two forms:
“One, termed ‘diphros,’ often had four perpendicular legs and a rectangular seat, often with a cushion or rug for padding.
“The other stool became known as ‘diphros okladias’ in which the legs cross, as in the modern stool.”
Benches Became Common in Greek Culture
“The use of benches on which to sit became a common part of Greek culture, used in schools and theaters and by philosophers and their audiences. The bench sometimes had perpendicular backrests, but this was not common.”
Greek Speaker Would Sit in Throne-Like Chair
“The Greeks were also accustomed to sitting on the ground.
“Significantly perhaps, the ‘speaker’ would sit in an almost throne-like chair, setting him/her apart from the audience.”
The Roman Era (369 B.C. – Fall of Rome)
“The Roman Era – The Romans did not develop the furniture of the Greeks much further. Rather, they kept the designs and added to the ornamentation and decoration.
Thrones in Rome Became Seat of Power
“General styles similar to those of the Greeks were found distributed throughout the Roman Empire. Thrones became quite distinctive, and certainly in Rome the chair was a ‘seat of power.’
“The collapse of the Roman Empire signals an end to the furniture seen in these times.”
The Byzantine and Early Medieval Eras
“The Byzantine and Early Medieval Eras –
“‘When the nomads plundered Rome, they found chairs that made no more sense to them than the statues, the thermae (a public bathing establishment of the ancient Greeks or Romans), the inlaid furniture, and all the instruments of a differentiated culture. Their habit was to squat on the ground, and so it remained,’ (Geidion, 1948).”
Much of Antiquity Abandoned
“The traditions of the classical arts were, however, not completely lost. The Christians took over the ‘classical figures’ and adopted them to their own uses.”
“‘Much of the legacy of antiquity was abandoned. All those lovely subtle curving shapes seen in Greek and late Roman furniture, the rounded backs and the sweeping saber legs have vanished,’ (Hayward, 1975).”
“The chair takes on an architectural form, usually massive in construction, and with a straight back. The old skills had been swept away; and the craftsmen of this time, using construction methods similar to older times, remodeled the chair anew. It was severe in its form; and it was only used by figures of power and authority, and for ceremonial purposes. Comfortable support did not seem a consideration.”
The Gothic Era
When was the Gothic Era?According to Wikipedia – It evolved from Romanesque architecture and was succeeded by Renaissance architecture. Originating in 12th century France and lasting into the 16th century, Gothic architecture was known during the period as Opus Francigenum (“French work”) with the term Gothic first appearing during the later part of the Renaissance.
“The Gothic Era – The early Gothic period was a time without the chair for the general population.”
“The three-legged stool remained a part of everyday life, but sitting was a very informal affair.”
“‘People sat on the bare floor and used cushions. They sat on stairs and steps leading up to the high-posted beds. Romanesque chests were for sacred purposes and much too high to have been used as seats. As chests became lower, we find them aligned along walls. They filled the role of chairs and couches,’ (Geidion, 1948).”
The Universal Furniture of the Middle Ages
“The chest became the developed universal furniture of the Middle Ages. Chests were portable, capable of storing one’s belongings; and they could be used to sit upon.”
The Gothic Era – Transience of Abode
“A characteristic part of Medieval life was transience of abode. Living situations were often temporary, even with the nobility and kings, who traveled with all their worldly belongings, usually in a great chest.”
The Chest Becomes a Seat
“The chest’s metamorphosis to the seat came about as people became less nomadic and no longer required the security of a chest.
“As well, the chests of the time became quite ornate and uncomfortable to sit upon; and with the addition of the drawer, the chest began its development as a ‘chest of drawers.’
“The arrangement of chests around the walls became replaced by a continuous ‘bench skirting,’ sometimes the whole circumference of the room.”
Horizontal Tables Associated with Libraries
“The Gothic Chair and Desk – It was not until the Eighteenth Century that horizontal tables became the principal type of table for these types of activities, a period associated with the development of libraries. . .The sloped desk has never regained the popularity it had at this time.”
Modern History – 16th Century Onwards
“Modern History – From the Sixteenth Century onwards, chair design could be said to be of a European style; and in the Nineteenth Century, an American influence emerges.”
The Cabinetmaker Era – Middle 16th Century
“The Cabinetmaker Era – By the mid-Sixteenth Century, the chair was becoming a common piece of furniture throughout Europe.”
“Made by Cabinet-makers for the wealthy and noble members of society, the chair’s design continues to become more diversified, often to meet the fashion tastes of the privileged classes.”
“Chair design begins to move away from the heavy and harsh angular shapes to a lighter design using frame construction, similar to that of the earlier Greek chair, incorporating flowing curves and a backrest intended to support the seated person.”
Return of a Forgotten Standard – (Geidion, 1948)
“‘Typically speaking, it was the return of a forgotten standard:
“To create a support for the body that would allow highly relaxed posture. Posture and the chair are one,’ (Geidion, 1948).”
“The chair designs were influenced by the tastes of the upper class and more powerful members of the society. It represented an expression of their tastes in furniture and their rank.”
Napoleon Bonaparte’s Influence
“Perhaps a classic example of this type of influence is the role played by Napoleon Bonaparte, considered responsible for the resurgence in the Greek and Roman styles of furniture.”
“A throne is only a bench covered with velvet.” Napoleon Bonaparte
“‘Men born into the first decades of the Nineteenth Century grew up in the firmly-rooted belief that all products embodied high labor values and were to be won only by long toil. Now the machines began cutting to a fraction of their former cost not only cotton goods but every product used in art and adornment,’ (Geidion, 1948).”
The Upholsterer Era
“The Upholsterer Era – With the advent of new technologies, methods, and materials, the upholsterer emerges as the new chair designer. Chairs and stools had used cushions and limited upholstery previously but only in a small way to augment the woodworker.”
“‘New fabrics and many types and designs emerge from the textile mills; and the upholster finds many imaginative uses for them, none the least the adornment of chairs,’ (Geidion, 1948).”
Upholder / Upholsterer Standards
According to Wikipedia – “The Worshipful Company of Upholders is one of the Livery Companies of the City of London. “Upholder” is an archaic word for “upholsterer”.
“In past times upholders carried out not just the manufacture and sale of upholstered goods but were cabinet makers, undertakers, soft furnishers, auctioneers and valuers.
Right to Search, Seize and Destroy Defective Upholstery
According to Wikipedia -“The organization was formed on 1 March 1360 and officially incorporated by a Royal Charter granted by Charles I in the 1626. The Company originally had the right to set standards for upholstery within London, and to search, seize and destroy defective upholstery. However, over the years, the Company’s power has eroded, as has the profession of upholsterers, because of the advancement of technology.”
The Patent Era
“The Patent Era – Paralleling the rise of the upholsterer, other technologies were developing in the rapidly industrialized world. New ideas, materials, and methods gave rise to the ‘Patent Era’ in furniture design, which particularly flourished in the new colony of America.”
“Patent designers, inventors, and general gadget-makers turned their energies to chair design. The notion of adjustability and flexibility of design was paramount as the new engineers dissected the chair into its planes, making each capable of regulating movement. . .Patent designers left few stones unturned in their quest for relaxing and comfortable designs.”
Ergonomics in the 1870’s
“The American Patent Office in the 1870’s had 70 sub-divisional categories for chairs of different purposes.”
Ergonomics in the 1880’s
“Some of these designs were grotesque and awkward, while others took account of the human (factors). . .anonymous patent designers were developing the first ‘ergonomic’ chairs, in the late 1880’s.”
Rocking Chair Invented to Minimize Back Pain through Ergonomics
“Backache from sitting was recognized and accepted as a challenge by the Patent designers; and as a result, the rocking chair was developed. This form was then merged with the revolving chair. Springs (were) attached to the adjustable backrest, allowing the sitter to move anteriorly or posteriorly with continued support. At least that was the theory.”
President Lincoln Assassinated in Rocking Chair
According to Wikipedia – “Henry Ford purchased the rocking chair that President Lincoln was sitting in when he was assassinated on April 14, 1865, in 1929 for the Museum, where it remains one of the most revered objects associated with the “man who saved the Union.” You can view the chair at the Museum or online atthehenryford.org.”
President Kennedy Traveled with Rocking Chair to Minimize Back Pain through Ergonomics
According to Wikipedia – “In 1955, President Kennedy, who suffered with chronic back problems, was prescribed swimming and the use of a rocking chair by his physician.
“The President so enjoyed the rocker that, after he was inaugurated in 1961, he took the chair on Air Force One when he traveled around the country and the world. He bought additional rockers for Camp David and for the Kennedy estates; and he gave them as gifts to friends, family, and heads of state.
“Kennedy’s rocking chair from the White House is on permanent display at the John F. Kennedy Library and Museum.”
The Office Chair
“The ‘office’ chair becomes a common part of the industrial age, while other specialized chairs fill market niches.
The Forward Sloping Typist Chair – Ergonomics in the 1880’s
“The typist chair, which did not appear until the late 1880’s, some twenty years after the introduction of the typewriter, received considerable attention to its design. The seat was often capable of sloping forwards, as was common in ‘sewing machine’ chairs of the time.”
The Architect Era
“The beginning of the Twentieth Century was a time of revolt against the Patent furniture movement. Furniture was becoming an integral part of the house and office setting, with function assuming lesser importance to form. Aesthetic design became the guiding force, with the chair’s place within (the room), and its interaction with the space of the room of prime consideration.”
German Bauhaus School – Architects
“Around the 1920’s, the architects become the new guardians of chair design philosophies emanating from the German Bauhaus School. . .The architects approached the chair as a form, rather than as a functional unit as seen in the ‘Patent Era.’
“Along with this change in emphasis, the architects and their forms were to become famous for their work, as leaders in the avant grade world of design.
“Chair designers were no longer anonymous craftsmen or patent-holders; but rather, they became prominent social figures in their societies.”
The Industrial Designer Era
“Chair design and manufacture by this time had become big business, resulting in the further specialization of its designers. The architects were left to design buildings, with a new profession, the ‘Industrial Designer,’ assuming the chair as part of their portfolio of concerns.”
“New philosophies of design emerged from this group. Styles become formalized with perhaps the most prominent of these being ‘streamlining,’ as seen in the cars, appliances and furniture, with curves and flowing lines used to accentuate the ‘modern.’ Furniture was freely available to the masses and the new consumer tastes that were developing.”
The Post Modernist Era
“Chair design and the marketing of chairs divided into basically three distinct types to meet the demands of the consumer.
“Chairs designed for institutional purpose;
“Chairs designed for the home and general consumer use; and
“Chairs as a form of artistic expression.”
Designers, Architects, and Artists Attracted to Designing Furniture
“Nearly all designers, it seems, are attracted to designing a piece of furniture.
“Architects are convinced the chair is architecture writ small.”
“Industrial designers are intrigued by the problem of combining mass-manufacture, modern materials, new technology and good looks in a field which, unlike that of other consumer durables, has in the past resisted change; and men and women who would previously become fine artists have adopted furniture as a medium for self-expression and comment, (Dormer, 1987).”
The Ergonomics Professional as Office Chair Designer
“The office or work chair has become a challenge for industrial designers and most recently in the scientific community in the guise of the ergonomics professional or ‘Ergonomist.’
“Earlier designs of the ‘contemporary chair’ are reminiscent of the ‘Patent Era,’ with movable backrests, adjustable seat heights and pivoting seat pans.”
No Correct Sitting Posture
“In an ad hoc evaluation of office chairs (1985), a design journalist, Helen Butterly, asked various professionals to assess a number of office chairs. . .There are several chairs which are good and which seem comfortable, but no one can agree which is the best since sitting remains a personal activity.
“Butterly learned the current ergonomic tenet: There is no correct sitting posture, and it is good for the spine to be in constant movement.”
“The orthodoxy in office chairs now is a backrest that moves with the sitter.”
Testers Concluded People Need to Learn to Sit Properly
“One of the testers concluded that you really need to learn to sit properly and then you would not be in need of gimmicks; but because many people do not learn to sit properly, the designer’s task is to accept this as one of the ‘givens’ and design in those very features which are too easily dismissed as gimmicks, (Dormer, 1987).”
“This rather contentious notion has become the hallmark of ergonomics research in the area of sitting. ”
Western Culture Still Not Sure of Best Sitting Posture
“In Western society, the chair has become integral to the notion of posture. To suggest, after the long evolution of the chair and supported sitting in Western culture, that we are still not quire sure how to best sit people, is an interesting question, about which a great deal of ergonomic research has concerned itself.”
Kim Gurr’s Reference List:
Dormer, P., 1987: The New Furniture, Trends and Traditions
Hayward, H. 1975: World Furniture
Baker, H.S., 1966: Furniture in the Ancient World
Geidion S., 1948: Mechanization Takes Command, A Contribution to an Anonymous History